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59 Cards in this Set

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  • Back
What is an axiolytic?
AKA Sedative, makes you calm
What is a hypnotic?
Produces drowsiness
Drugs that Cause sedation as a side effect?
Antihistamines and neuroleptics
What is a Sedative Hypnotic?
1. Anxiety reducers that cause Sleep at high doses
What is anxiety?
1.Adaptive response to a threatening event
2. Hyper vigilance
What is chronic anxiety?What kind of problems come with it?
1. Maladaptive response
2. GI, CV and neuro problems
What is the neurological structure of anxiety?
1. Amygdala
What period do the anxiolytics work on?
During the anticipatory peroid
What is acute anxiety caused by?
Specific Events
What is panic disorder?
Acute sever anxiety with the sense of impending doom
What is GAD? What do you treat it with?
1.Persistant state of fear and apprehension about the future.
2. Buspirone
What do the Benzo's end in except 1?
PAM or LAM except chloridzepoxide
What do the Barbituates end in?
TAL
What are the antihistamines?
1. DPH or OH
2. -INE
What are the non-sedating anxiolytics?
1. Buspirone
2. Propranolol
What is Buspirone?
1. Treat GAD
2. A Serotonin-R agonist
What are the 3 Z's and what do they do?
1. Zolipedem, Zalaplom, and esZopiclone
2. Bind GABA-a
3. Used for sleep
What drugs are used the most as sedative-hypnotics?
1. The BZDs, safer than Barbs
2. Carbamates and alcohol are others
What are the five levels of CNS effects?
1.Sedation/Anxiolysis/Disinhibition
2. Hypnosis
3.Anesthesia
4. Medullary depression
5. Coma
How far do Benzos go vs. Barbs in CNS dose dependent effects?
Benzos get to anesthesia and and little medullary depression.

Barbs can go all the way to coma and death
What is the number 1 script for panic disorder?
Alprazolam
What are the common benzo's used for anesthesia?
1. Diazepam
2. Midazolam
What is the goal for dosing and how is it accomplished?
To take less dosage usually by increasing the half life. Tis is for better complaince
Name some short, intermediate and long lasting benzo's and their 1/2 life?
1. Midazolam(colonoscopy) - 2-6hours
2. Alprazolam(panic disorder) - 12-15hrs
3. Diazepam (Seizure) - 20-80hrs
Where are basic drugs absorbed? What does this say about time of action?
1. BZD absorbed in Duodenum
2. Late onset
What are the acid anxiolytics and where are they absorbed? What time of action?
1. Barbs in the stomach
2. Rapid onset
When given benzo's or barbs in an IV which one has a slower dose response curve?
Neither they have the same
What is the receptor target for Benzo's?
GABA-a-R
What is the MOA of Benzo's?
1. Gets GABA to GABA-a
2. The CL- channels open more
What is Diazepam used for?
Anxiolytic and anticonvulsant.
What is the electrophysiological response to valium?
Increased IPSP
What does an antagonist do to the electric potential?
It will do nothing, can be used as an antidote
What will an inverse agonist of GABA-a do?
Make you anxious
GABA-R alpha 1 has what effect? Where is it localized?
What Drugs?
1. Affects sedation
2. Cerebellum, and cortex
3. Ambien and the 3 Z's
What does the GABA-a-R subunit alpha 2 and 3 do? Where is it localized?
1. 2 is Anxiolysis and 3 is anxiogenic
2. Amygdala
What does GABA-a-R subtype alpha 5 do? Where is it located?
1. Decrease cognition with BZD
2. BZD will get you stupid
3. Hippocampal region
What is the antidote to BZD?
1. Flumazenile
What doe Zolpidem and Zaleplon do?
1. Short acting
2. easy sleep with little side effects
What does esZoplicone do?
1. Long acting
2. For chronic insomnia
What are the MOA of Barbs?(3)
1.Bind GABA-a-R, and depress the RF
2. Glycine and GABA have more effect
3. Inhibit AMPA glutamate-R = DEATH
What is the buspirone MOA?
1.12 degree agonist of serotonin 1A
Where do the 3 Z's hypnotic drugs bind?
Same place as the BZD
What is sedation?
Decreased level of responsiveness to constant stimulation
What is hypnosis? And the problem with these drugs?
1. Sleep
2. REM is usually decreased
3. Withdrawal may cause REM rebound
What do the effects of sedative-hypnotics depend on?
Depend on the lipid solubility(barbs is high)
What are the most lupid soluble sedative hypnotics?
Barbs such as Thiopental and methohexital

They quickly penetrate the brain tissue
What sedative hypnotics are generally used as anesthetic agents?
Midazolam and Diazepam, usually in adjunct.

Diazepam cannot work alone
What are the 3 anticonvulsant BZD and Barbs?
1. Phenobarbital, Diazepam, Lorazepam
2. Must administer intravenously
What sedative hypnotics would you use for muscle relaxation?
Most are not used because of high CNS depression, use Diazepam for specific spasiticity like cerebral palsy
What is the dangers of sedative hypnotics?
At high doses can cause medullary depression and death

At therapeutic doses can affect patients with COPD to supress respiration even more
What is tolerance?
A decrease in responsiveness to the drug to where increased levels needed to achieve same response
What is physical dependence?
Synapse remodelling

Can cause the body to actually need the drug to prevent the symptoms it was used to treat

More common in shorter acting and unlikely in Buspirone
What sedative hypnotics would be used for Anxiety?
BZDs becuase low levels do not impair motor
#1 drug for panic disorder and agoraphobia
Alprazolam
What are the adverse effects of sedative hypnotics?(3) Other contra indication?
1. Excess CNS depression
2. Decreased pyschomotor
3. Drowsiness/dizziness

4. Usually occur in ones with long half lives like Flurazepam
5. Make sure the elderly do not get overdosed
What is additive CNS depression?
1. Sedative hypnotics with CNS depressants are additive
2. Ethanol most common
3. Buspirone lease additive
What is Cimetidine?
1. Decreases metabolism of drugs, will increase the effects
2. H2 antagonist for Heartburn
What is Flumanizile?
Benzo Antagonist, not for barbs